关节镜下修复配合痛点注射治疗肩袖损伤的中短期效果分析

Short and Middle Term Effects of Arthroscopic Repair Combined with Pain Point Injection in Treating Rotator Cuff Injury

目的:探究关节镜下修复配合痛点注射治疗肩袖损伤的中短期效果。方法:选取2020年6月-2023年6月龙岩市第一医院77例肩袖损伤患者为研究对象,根据手术方法的不同将其分为观察组(n=39)及对照组(n=38)。对照组给予小切口肩袖修复术治疗,观察组行关节镜下修复配合痛点注射治疗,所有患者均随访3个月并进行复诊。采用美国肩肘协会(ASES)评分、美国加州大学肩关节功能(UCLA)评分评价患者手术前后肩关节功能,根据患者术后UCLA评分对临床疗效进行评价,并应用电子握力器评估患者肩关节肌肉力量,比较两组患者术后疼痛程度,手术前后肩关节活动度、肩关节结构参数。结果:观察组治疗优良率高于对照组,差异有统计学意义(P<0.05)。观察组手术时间短于对照组,术中出血量少于对照组,切口长度短于对照组,差异有统计学意义(P<0.05)。观察组术后3 d、7 d及术后2周的视觉模拟评分法(VAS)低于对照组,观察组术后UCLA评分、ASES评分及肩关节肌肉力量大于对照组,观察组术后前屈、外展、体侧外旋、后背内旋活动度均大于照组,差异有统计学意义(P<0.05)。两组术后肩峰-肱骨头间距(A-H)及肱骨头上移系数(UMI)大于术前,差异有统计学意义(P<0.05);但组间术后3个月A-H、UMI对比,差异无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:关节镜下修复配合痛点注射治疗肩袖损伤的中短期效果较好,可减轻患者术后疼痛,并能提高肩关节活动度,促进肩关节功能恢复。

Objective:To explore the short and middle term effects of arthroscopic repair combined with pain point injection in the treatment of rotator cuff injury.Method:A total of 77 patients with rotator cuff injury in the First Hospital of Longyan City from June 2020 to June 2023 were enrolled as the study subjects,and they were divided into observation group(n=39)and control group(n=38)by means of different surgical methods.The control group was treated with small incision rotator cuff repair,while the observation group received arthroscopic repair combined with pain point injection.All patients were followed up for 3 months and revisited.American Shoulder and Elbow Society(ASES)score and the University of California at Los Angeles shoulder rating scale(UCLA)score were used to evaluate the shoulder function before and after surgery.The clinical efficacy was assessed according to the postoperative UCLA score.Electronic grip strength device was used to evaluate the shoulder muscle strength of patients.The postoperative pain degree,and shoulder range of motion and shoulder structure parameters before and after surgery were compared.Result:The excellent and good rate of treatment in observation group was higher than that in control group,the difference was statistically significant(P<0.05).The surgical time in observation group was shorter,the intraoperative blood loss was less,and the incision length was shorter than that in control group,the differences were statistically significant(P<0.05).Visual analogue scale(VAS)scores in observation group at 3 d,7 d and 2 weeks after surgery were lower than those in control group,the UCLA score,ASES score and shoulder muscle strength in observation group were higher after surgery,the anteflexion,abduction,external rotation of the body side and internal rotation of the back were greater in observation group after surgery,the differences were statistically significant(P<0.05).The postoperative acromion-humeral head distance(A-H)and humeral head upward displacement coefficient(UMI)in both groups were higher than those before operation,the differences were statistically significant(P<0.05);however,there were no significant difference in A-H and UMI 3 months after operation between groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion:Arthroscopic repair combined with pain point injection has good short and middle term effects on rotator cuff injury,and it can relieve postoperative pain,improve shoulder range of motion and promote shoulder function recovery.